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I have been diagnosed with mixed sleep apnea but predominantly Central Sleep Apnea (CSA). The sleep specialist that is treating me has suggested that the benefits derived from using a VPAP machine as opposed to a CPAP will not result in a benefit that justifies the additional cost. I have tried both CPAP & VPAP Machines in the Resmed S9 Series and found them to be good. I noticed today that CPAP1800 is selling a Phillips Respironics Auto BiPAP With Heated Humidifier for $1,299, which is significantly cheaper than the Resmed VPAP machine. However, I have had no experience with any of the Phillips products. Can anyone who has some knowledge please pass on their opinion of the machine and also any suggestions regarding the treatment of CSA. Also, Modavigil is anly subsidided in Australia for sufferers of narcolepsy. To buy it without subsidy costs in excess of $300 per month. Can anyone please recommend an alternative? Thanks a million

(02-12-2013, 03:49 AM)1derphil Wrote: I have been diagnosed with mixed sleep apnea but predominantly Central Sleep Apnea (CSA). The sleep specialist that is treating me has suggested that the benefits derived from using a VPAP machine as opposed to a CPAP will not result in a benefit that justifies the additional cost. I have tried both CPAP & VPAP Machines in the Resmed S9 Series and found them to be good. I noticed today that CPAP1800 is selling a Phillips Respironics Auto BiPAP With Heated Humidifier for $1,299, which is significantly cheaper than the Resmed VPAP machine. However, I have had no experience with any of the Phillips products. Can anyone who has some knowledge please pass on their opinion of the machine and also any suggestions regarding the treatment of CSA. Also, Modavigil is anly subsidided in Australia for sufferers of narcolepsy. To buy it without subsidy costs in excess of $300 per month. Can anyone please recommend an alternative? Thanks a million

Hi 1derphil, welcome to Apnea Board,

The VPAP Auto or BiPAP Auto machines are not designed for Central Apnea, but the ASV machines are.

The new model 36037 (or 36047 if humidifier is included) ResMed S9 VPAP Adapt machines manufactured in Nov 2012 and later have a different model# than (but same model *name* as) older S9 VPAP Adapt machines and are able to treat central apneas just like the older machines are but also have an improved ability to treat obstructive apneas. On the older S9 VPAP Adapt machines the exhale pressure is only adjustable manually and the IPAP (inhale pressure) automatically adjusts itself to prevent central apneas. The new model automatically adjusts both the inhale and the exhale pressures.

The Philips Respironics System One BiPAP Auto SV Advanced is a great machine and also automatically adjusts both the inhale and exhale pressures, to optimally treat both obstructive and central apneas, and is more adjustable (customizable) than the S9 VPAP Adapt. The S9 VPAP Adapt is more of a "one size fits all" machine, with fewer options for customization.

Supplier #2 occasionally has used ASV machines and open box specials on new ASV machines. If you have primarily Central Apnea, really - ASV is definitely worth the extra cost, especially if you can wait perhaps a month or two for one to become available at Supplier #2.

But if buying the S9 VPAP Adapt, CALL BEFORE BUYING AND ASK FOR MODEL# so you will know whether you would be buying the model 36037 (36047 with humidifier) or the older version.

Take care,
--- Vaughn

Update: I just checked Supplier #2 and they have both new and used units now.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.

First, we need to know which Resmed S9 machine you have now. It should say something near the power button like Elite, AutoSet, etc.

BiPAP and VPAP are trademarks for bilevel machines. Bilevel may help your central apnea, but that's not really what it's designed for. It might even make it worse. Sometimes, you just have to try it and see what happens.

You may also find that the higher the pressure you use, the worse your central apnea gets. Sometimes you can balance out central vs. obstructive by choosing the right pressure. Sometimes, using EPR may change your numbers for better or worse.

Some bilevel machines have timed (T) mode or spontaneous/timed (ST) mode, which is more likely to help central apnea than normal bilevel machines. "Normal" bilevel is spontaneous (T) mode.

The best solution by far for central apnea is an Adaptive Server Ventilator (ASV) machine. It makes a lot more adjustments to fix your central apnea.

To further confuse the issue, "ASV" machines are often classified as "bilevel/BiPAP/VPAP," which may technically be true, but there's a quantum level difference in how they work.

Also, don't panic about apneas just because they're central. Central is harder to get rid of, but not necessarily more harmful to your body. If they're not too often or to long lasting, you may be able to live with them.

Get the free SleepyHead software here. Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.

It is the ResMed VPAP Adapt that is for mixed or Central apnea. From what I can tell, it is their only S9 for this. The other is the S8 Adapt SV.
The S9 VPAP Auto is for "non compliant" patients with OSA.
The S9 VPAP ST and ST-A seem to be bilevel ventilators with pressures up to 30.
The S9 VPAP S is another bilevel.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

The alternatives to Nuvigil or Provigil are other CNS stimulants- ritalin, adderal are two brand names. With the exception of Ritalin the other drugs are probably harder to get prescribed. Nuvigil and Provigil are supposed too be less habit forming than the alternatives. My cousin used to take desoxyn for narcolepsy. These drugs are usually controlled and require a new prescription every month in the US.
I took both Provigil and Nuvigil for excessive daytime sleepiness for a long time with good results, but at that price... I don't know.

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.